Any ICU travel RNs who've worked at a Kaiser hospital?

I am a new hire at Kaiser in my 90 day probation period. I have experience in ICU, trauma and organ donation. I consider myself quite competent and never afraid of a tough assignment or hard work.

Sunday night I got the following assignment: 70 yo female. Ca colon colectomy done early April. Transferred from MS w/ST at 170, RR 40's & bp 85/_. Unstable with Diltiazem, BP 65/_. I had a very clear but respectful conversation with the 913 MD,Kaisers version of a hospitalist. I suggested to her that the patient was more appropriate to the ICU, and would have more direct care than on the DOU. I pointed out that the pt. would share me with 2 other patients. I even approached the ADA who later told me I should have gone to the charge nurse first. (P.S. the off going nurse was crying, literally, her day was so bad.) The 12 hour care included a trial diltiazem gtt, 2 reinforcements of her stool leaking wound vac, accu checks, 2 dig bolus, amiodorone bolus and drip, PCA, accuchecks and q2 hour turns.

My other patients included an elderly man under the care of an outside contractor, and a Kaiser hematologist. And a bed bound chronically ill man.

I was expected to care for an unstable ICU level patient and 2 other patients. My elderly patient had 6 units FFP ordered as his coags were unstable 2nd to a blood discrasia. I did not get in report that he had had blood transfusion reactions in the past. During the 1st transfusion he had a reaction. HR 130, BP217/110, diaphoretic, lethargic with a temp change. He was on accuchecks, multiple meds and required ambulation assist the to bathroom. After his reaction I had to call both the contracting MD, a competent and respected physician, the hematologist . I had to listen to the hemotologist bad mouth the contracting MD claiming that was "killing his patient".

My chronically ill patient required turning and was being aggressively diuresed. Urinal drills twice an hour. He had a Stage II which I was not told of in report which required a photo and dressing change. And he was awake and chatty and deserved some of my time.

I initially thought the charge nurse had my back because she seemed to be there with any new meds, but I found out later that the hospitalist had told her that she didn't trust me and I couldn't take care of the patient. Instead of taking over the patient she let me participate in the care. She was taking verbal orders from the MD. Although I acknowledged orders in a timely manner on the computer I discovered most orders were already executed by her. I didn't really get to be there for several drip starts and stops. The doctor didn't have a plan, diltiazem was tried, amiodorone was bolused and started by the charge nurse, cardioversion was discussed and declined by the hospitalist but subsequently the patient sat with a low BP, HR 150+, and RR 30-40 all night, and about 50% of the charting was done by the charge.

I ran my ass off all night. Not one nurse stopped their texting breaks to help me. I was stunned I have never worked on a unit where the nurses didn't have one another's backs. At 0630 I was told by the same ADA that I needed to take a break or Kaiser "would get dinged". I clocked out, went in the back, and charted while I ate.

I gave what I think was the worst report of my life on the tachycardic patient. But both nurses to whom I gave report, they split up the assignment, were going to petition for ICU transfers for their patients.

Not a lot bothers me but I left so tired and so physically and emotionally wrecked I am thinking of not going back. I could lose my license with assignments like that.

After all of this I was called into the ADA office, who wanted to discuss a complaint that I was rude. She described a situation on an orientation day in which the charge nurse, an Asian woman, told me, in a not so appropriate tone, not to stand with my hands on my hips. She claimed that some cultures find it offensive and that it had been a problem addressed at Kaiser. I was stunned. I was told by a friend who had worked as a traveler in this ICU that he felt this same charge nurse had treated him badly based on his skin color. The assignment on the shift described above was made by this charge. At the end of huddle she made the statement "ok everyone, this assignments are hard tonight, the patient acuity is high. Don't complain".

I would like some feed back from you please. Has anyone else had such a dangerous assignment from Kaiser?

Leslie

I just finished, actually leaving for a medical emergency, contract at Kaiser Bellflower, in CA. After getting the job at Kaiser Sunset and 3 days before fly time, they canceled my contract and said "they over interviewed" They sent my file on to Bellflower to compensate? East of Long Beach area.
It was awful! I was one of the only Caucasian persons working most days and they treat you terribly! They are just starting to warm up to me and ask me if I need help, this past few shifts!! They sit around and talk while you run your ass off! They float you like crazy, although, I was lucky because the unit I was in really needed me. (being one of the few ICU trained nurses on a step down) They floated all the DOU (step down) to ICU and all the floor nurses floated to DOU and they are not capable of taking gtts and vents and they are in over their heads! Unsafe environment, nobody cares. You serve and fee all your patients, no care techs! The management and supervisors really don't acknowledge you. They will call you at 10pm at night to ask something about charting! They won't pay you for anytime you worked past your 12 hours, which happened half of my contract! They want you to have a DAY supervisor sign it and approve it, when they are gone at 2030??! You are suppose to call for help throughout the day to prevent this. Whatever! So, I will never work Kaiser again, after 7 years of ICU travel nursing. FYI, don't go to the DOU at Kaiser Bellflower. Most of the nurses are not nice, you are busy as hell and nobody helps you unless your pt is ready for intubation or crashing and when you are gowned in a room and your pt is laying in a hug code brown, asking for help gets you a response like "what does she need in there?" (talking to another nurse, thinking I can't hear her) REALLY!! You got the jest of it!